ObjectiveThis study aims to summarize the risk factors and therapeutic strategies for early recurrence after hepatocellular carcinoma (HCC) resection, so as to provide a reference for the prediction of postoperative early recurrence and the treatment of recurrent HCC. MethodsThe article gives a summary of the risk factors for early recurrence and treatment after hepatectomy for HCC by searching for relevant studies at home and abroad in recent years. ResultsHCC is a common and highly fatal malignant tumor worldwide. Surgical resection remains the preferred treatment method, but the early recurrence rate (recurrence within 2 years after surgery) is as high as 40%-50%, which seriously affects the prognosis of patients. The risk factors for early recurrence of HCC include patient factors (gender, marital status, liver status, inflammatory indicators, nutritional status, etc.), tumor factors (tumor markers, diameter, number, degree of differentiation, margin and capsule, microvascular invasion, satellite nodules, etc.) and surgical factors (whether anatomical resection or not, resection margin, perioperative blood transfusion, etc.); treatment methods include reoperation (laparoscopic, open), salvage liver transplantation, radiofrequency ablation, interventional therapy (transarterial chemoembolization, transhepatic arterial infusion chemotherapy, transarterial radioembolization) and systemic therapy (targeted immunotherapy, antiviral therapy and traditional Chinese medicine therapy). ConclusionEarly recurrence after HCC hepatectomy severely compromises the long-term survival of patients. Going forward, efforts should be devoted to developing accurate prediction models for postoperative early recurrence, further clarifying the optimal therapeutic regimens for recurrent HCC under different clinical scenarios, and providing evidence for individualized treatment to improve the overall prognosis of patients.
Objective To explore the safety and costs of orthopedic robot-assisted treatment of calcaneal fractures. Methods The data of patients with calcaneal fractures treated by surgery in Beijing Jishuitan Hospital between January 2021 and July 2022 were retrospectively analyzed. Propensity score matching was used to match 1∶4 patients with orthopedic robotic-assisted closed reduction and internal fixation of calcaneal fractures (orthopedic robotic group) and traditional open reduction and internal fixation surgery (traditional surgery group). The safety and costs were compared between the two groups after matching. Results A total of 253 patients were included and divided into orthopedic robotic group (11 cases) and traditional surgery group (242 cases) according to different surgical methods. Before propensity score matching, there was no significant difference in age, gender, diagnosis and comorbidities between the two groups (P>0.05). After propensity score matching, there were 11 patients in the orthopedic robotic group and 44 patients in the traditional surgery group. There was no significant difference in age, gender, diagnosis and comorbidities between the two groups (P>0.05). There was no significant difference in height, weight, body mass index, operation duration, average postoperative pain score, and highest postoperative pain score between the two groups (P>0.05). The intraoperative blood loss [10.0 (10.0, 20.0) vs. 20.0 (20.0, 50.0) mL], total length of hospital stay [(4.5±1.3) vs. (8.7±3.7) d], and postoperative length of hospital stay [(2.3±1.1) vs. (4.5±2.3) d] in the orthopedic robotic group were less than the traditional surgery group (P<0.05). There was no significant difference in the total hospitalization costs, rehabilitation costs, inspection and examination costs between the two groups (P>0.05). The surgical cost of orthopedic robot group [1413.7 (1287.7, 1790.8) vs. 2331.2 (2195.1, 2548.6) yuan], total ward cost [(3154.5±1213.7) vs. (5711.9±2147.4) yuan], ward consumables cost [(1407.0±942.0) vs. (2409.4±1458.2) yuan], ward medication costs [(257.1±146.6) vs. (846.7±525.2) yuan], ward diagnosis and treatment costs [(901.6±366.6) vs. (2010.5±830.6) yuan], nursing care costs [(159.6±46.1) vs. (345.2±174.7) yuan], total postoperative costs [(2370.4±1324.0) vs. (3888.6±1554.9) yuan], postoperative care costs [(105.4±52.2) vs. ( 205.6±128.2) yuan] were lower than the traditional surgery group (P<0.05). Conclusion Orthopedic robot-assisted treatment of calcaneal fractures can effectively reduce intraoperative blood loss, shorten hospitalization time, and have good safety. At the same time, it can reduce operating costs, total ward costs, ward medication costs and nursing costs.